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 v-y plasty  A surgical method for lengthening tissues in one direction by cutting in the lines of a V, sliding the two segments apart, and closing in the lines of a Y.. V-Y plasty technique is common in plastic surgical practice. This technique is probably described by Blasius (McCarthy JG, 1990). In this technique, an incision is made as V pattern and the V patterned skin is approached to cover the defected area as Y shape. Most authors offered the technique as a reliable method for reconstruction of relatively small defects (Parry S et al, 1989; Khatri VP et al, 1994). There is a lot of methods to cover defects in plastic surgery. The V-Y plasty among these techniques is one of the most reliable methods (Nilson RZ et al, 1995). Although V-Y plasty is a common procedure to cover the defect it has limited usage in covering of lower extremity defect. Various flaps have been used to cover the plantar defect of the foot. below is some example of v-y plasty in surgery.

1-finger tip amputation In 1970, Atasoy and associates described a triangular volar “V-Y” advancement flap for reconstruction of the distal pad with preservation of length when bone is exposed in fingertip amputations. It is indicated for dorsal oblique or transverse distal fingertip amputations beyond the midpart of the nail. The flap is contraindicated in injuries in which there is an oblique amputation with more palmar skin loss than dorsal skin loss and in situations in which there is extensive skin loss as a result of the injury. A pattern may be made to cover the dimensions of the defect and then transposed proximally to the cut edge of the skin that is to be advanced. The base of the triangle will be the distal cut edge, and an appropriate triangle of skin is made according to the pattern, with the apex of the triangle being at the DIP flexion crease. The two sides of the triangle should be at least 1.5 times the length of the desired advancement. Only the full thickness of the skin is cut. The digital nerves and blood vessels of the flap are preserved. Its blood supply is from the small arterial branches of the digital arteries distal to the trifurcation of the digital nerves. Separation between the flexor sheath and subcutaneous tissue is performed by dividing the fibrous septae that anchor the subcutaneous tissue to the bone, which facilitates advancement of the flap distally. The skin of the flap must be connected to the subcutaneous tissue to maintain its viability. The base of the triangle is carefully contoured and sutured to the nail bed or remaining nail, and the resulting “V” incision on the palmar aspect of the digit is closed, thus converting it to a “Y”. The Tourni-Cot or Penrose drain is removed prior to flap insetting to ensure its viability. The flap can be adequately mobilized up to 1 cm and if necessary defatted to facilitate tension-free skin closure.

2-reconstruction of defects on the nasal dorsum Burget and Menick and Yotsuyanagi et al  treated the nasal dorsum and other regions of the nose as separate units. Various local flaps have been described for reconstruction of tissue defects on the dorsum of the nose. These flaps originate from the nasolabial sulcus, glabella, forehead and malar area. Burget and Menick treated the nasal dorsum and side walls separately, and used cheek advancement flaps in the reconstruction of the side walls. However, this technique leaves visible scars and a flat dorsum. Millard, Burget and Menick , and Ogino used forehead flaps in repair of the nasal dorsum, and obtained good cosmetic results. This was supported by Yotsuyanagi et al. Although various skin flaps were described, there was still debate about the ideal technique, because most of these techniques had some disadvantages such as colour mismatch, dog-ear formation, thickness of flaps and requirement of other surgical steps for revision. However, V-Y plasty had a limited use in the repair of these defects. The new modification of V-Y plasty, called “distant V-Y plasty”, was easily used in defects of the nasal dorsum when the defect had a diameter of more than 0.5 mm, according to the classification of Burget and Burget.